Treatment for autoimmune hepatitis

Treatment for autoimmune hepatitis involves the use of corticosteroid drugs associated or not with immunosuppressive drugs and begins after the diagnosis made by the doctor through the analysis of the signs and symptoms presented by the person and the result of the requested laboratory tests, such as measurement of liver enzymes, immunoglobulins and antibodies, and liver biopsy analysis.

When the person does not respond to treatment with drugs or when the disease is already at a more advanced level, the hepatologist or general practitioner may recommend performing a liver transplant. In addition, to complement medical treatment, it is recommended that patients eat a balanced diet that is low in alcoholic beverages and fatty foods, such as sausages or snacks.

Learn more about autoimmune hepatitis.

Treatment for autoimmune hepatitis can be done with corticosteroids, immunosuppressants or, in the most severe cases, with liver transplantation. Usually, drug treatment for autoimmune hepatitis should be continued for life to keep the disease under control.

1. Corticoids

Corticosteroid medications, such as Prednisone, are used to reduce inflammation of the liver caused by the action of the immune system on liver cells. Initially, the dose of corticosteroids is high, but as treatment progresses, the doctor may reduce the amount of Prednisone to the minimum necessary for the disease to remain controlled.

However, the use of corticosteroids has side effects such as weight gain, weakening of the bones, diabetes, increased blood pressure or anxiety and, therefore, it may be necessary to make a combination with immunosuppressants to reduce side effects, in addition to the need for periodic monitoring by the doctor.

The use of corticosteroids is indicated for people who have more disabling symptoms, such as fatigue and joint pain, for example, when the person has very altered levels of liver enzymes or gamma globulins, or when the necrosis of the hepatic tissue stops in the biopsy..

2. Immunosuppressants

Corticosteroid drugs, such as Azathioprine, are indicated with the objective of decreasing the activity of the immune system and, thus, preventing the destruction of liver cells and chronic inflammation of the organ. Azathioprine is usually used in combination with corticosteroids in order to reduce the side effects associated with this treatment.

During treatment with immunosuppressive drugs, such as Azathioprine, the patient should have regular blood tests to assess the number of white blood cells, which can decrease and facilitate the onset of infections.

3. Liver transplantation

Liver transplantation is used in the most severe cases of autoimmune hepatitis, when the patient develops cirrhosis or liver failure, for example, and serves to replace the sick liver with a healthy one. Learn more about liver transplantation.

After the liver transplant, the patient must be hospitalized for 1 to 2 weeks to ensure that there is no rejection of the new organ. In addition, transplanted individuals must also take immunosuppressants throughout their lives to prevent the body from rejecting the new liver.

Despite being an effective form of treatment, there is a possibility that the disease will happen again, since autoimmune hepatitis is related to the person's immune system and not to the liver.

Signs of improvement of autoimmune hepatitis

The signs of improvement in autoimmune hepatitis usually appear a few weeks after the start of treatment and are related to the decrease in symptoms, allowing the patient to lead a normal life.

Signs of worsening autoimmune hepatitis

When the treatment is not done properly, the patient may develop cirrhosis, encephalopathy or liver failure, showing signs of worsening that include generalized swelling, changes in smell and neurological problems, such as confusion and drowsiness.